Vonderlin Ruben, Boritz Tali, Claus Carola, Senyüz Büsra, Mahalingam Saskia, Schmelz Julia, Knolle-Ventjeer Silja, Santangelo Philip S, Ebner-Priemer Ulrich W, Schmahl Christian, Margraf Jürgen, Teismann Tobias, Lis Stefanie, Kleindienst Nikolaus, McMain Shelley, Bohus Martin
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, J5, 68159, Germany.
German Center for Mental Health (DZPG), Partner Site Mannheim - Heidelberg - Ulm, Mannheim, Germany.
Borderline Personal Disord Emot Dysregul. 2025 May 9;12(1):15. doi: 10.1186/s40479-025-00294-3.
Borderline Personality Disorder (BPD) is a severe mental health condition that requires intensive psychotherapeutic treatment. Dialectical Behavior Therapy (DBT) is a specialized treatment approach for BPD with broad empirical evidence. However, as with other disorder-specific treatments, the effect sizes of the standard DBT approach are only modest and access to treatment is limited. To enhance the efficacy of DBT, we developed an adaptation called Trauma-Focused DBT (TF-DBT), which is based on the principles, treatment modes, and functions of DBT. The goal was to (i) condense and accelerate the core therapeutic processes of DBT and (ii) expand therapeutic strategies for addressing BPD symptoms beyond Stage I of DBT (i.e., focusing on behavioral dyscontrol). TF-DBT adopts an accelerated experiential approach that is phase-based in its delivery. It emphasizes the processing of maladaptive emotions related to a wide range of developmental relational trauma (i.e., experiences of traumatic invalidation, emotional abuse, bullying, sexual abuse, or neglect in childhood or adolescence).
The primary aim of this study is to investigate the efficacy of this novel DBT adaptation (TF-DBT) compared to standard DBT (S-DBT) as developed by M. Linehan. We hypothesize that TF-DBT is superior to S-DBT on all BPD symptom measures. A second aim of the study is to investigate the efficacy of the delivery format of both treatments (i.e., online vs. face-to-face), with the hypothesis that online therapy is non-inferior to face-to-face treatment.
This study will enroll N = 260 individuals diagnosed with BPD according to DSM-5. Participants will be randomly assigned to 12 months of outpatient TF-DBT or S-DBT in an online or face-to-face format.
The expected results might help to improve psychotherapy efficacy for BPD. Additionally, they will improve our understanding of the efficacy of online-delivered DBT treatments which might contribute to facilitating access to treatment.
German Clinical Trials Register: registration number DRKS00031808, date of registration 04 July 2023. WHO Universal Trial Number: U1111-1273-3381.
边缘型人格障碍（BPD）是一种严重的心理健康状况，需要强化心理治疗。辩证行为疗法（DBT）是一种针对BPD的专门治疗方法，有广泛的实证依据。然而，与其他针对特定障碍的治疗方法一样，标准DBT方法的效应量仅一般，且治疗机会有限。为提高DBT的疗效，我们开发了一种名为创伤聚焦辩证行为疗法（TF-DBT）的改编疗法，它基于DBT的原则、治疗模式和功能。目标是：（i）压缩并加速DBT的核心治疗过程；（ii）扩展治疗策略，以解决DBT第一阶段（即专注于行为失控）之外的BPD症状。TF-DBT采用一种基于阶段的加速体验式方法。它强调处理与广泛的发展性关系创伤相关的适应不良情绪（即童年或青少年时期的创伤性无效化、情感虐待、欺凌、性虐待或忽视经历）。
本研究的主要目的是调查这种新型DBT改编疗法（TF-DBT）与M. Linehan开发的标准DBT（S-DBT）相比的疗效。我们假设TF-DBT在所有BPD症状测量指标上均优于S-DBT。该研究的第二个目的是调查两种治疗方式（即在线治疗与面对面治疗）的疗效，假设在线治疗不劣于面对面治疗。
本研究将招募根据《精神疾病诊断与统计手册》第5版（DSM-5）诊断为BPD的N = 260名个体。参与者将被随机分配接受为期12个月的门诊TF-DBT或S-DBT治疗，治疗方式为在线或面对面。
预期结果可能有助于提高BPD的心理治疗疗效。此外，它们将增进我们对在线提供的DBT治疗疗效的理解，这可能有助于促进治疗机会的获取。
德国临床试验注册中心：注册号DRKS00031808，注册日期2023年7月4日。世界卫生组织通用试验编号：U1111-1273-3381。
